Community Reintegration After Rehabilitation for Hip Fracture: A Systematic Review and Meta-analysis
Authors: Beth Storr, Casey Peiris, David Snowdon
Link to article: https://doi.org/10.1016/j.apmr.2021.12.007
Beth’s position at Peninsula Health: Physiotherapy and AHA Student Coordinator
- What question did you set out to ask in your research?
We aimed to establish how we can assist people with hip fracture to return to living and participating in the community. Specifically, our review explored: What is the effect of rehabilitation on the physical, social and psychological dimensions of community reintegration after hip fracture?
- How did you go about doing it?
We carried out a systematic review and meta-analysis following the PRISMA guidelines.
We categorised our interventions as physical retraining (e.g. exercise), cognitive retraining (e.g. motivational interviewing), or models of care (e.g. home-based vs hospital-based rehabilitation).
Outcomes were more complex as there is no universally accepted measure of community reintegration! We categorised these using a theoretic framework as physical (e.g. ability to walk outdoors), social (e.g. attending events), psychological (e.g. confidence in community environments) – or a combination of these.
- What where the interesting findings and what does this mean for clinical practice? Did the findings raise new or unanswered questions?
Preliminary evidence suggests that physical retraining improves physical and social aspects of community reintegration. However, the effect of psychological and model of care interventions is currently unclear.
Further research is needed to determine the effect of rehabilitation on community reintegration, particularly psychological reintegration, – as well as measures that encompass all dimensions of community reintegration.
- What did you enjoy the most when doing this research?
The opportunities to: work through all of the stages of a systematic review – from protocol to publication, collaborate with experienced researchers internal and external to Peninsula Health, and be published in a journal that I frequently referenced and valued as a rehabilitation clinician. It was particularly satisfying to complete the review after the disruptions of the past 2 years.
- Do you have any advice for clinicians wanting to get into research?
As a novice myself, I would say don’t be afraid to give it a go, particularly if you are looking to diversify your skills and are interested in challenging and contributing to the body of evidence in your area. Peninsula Health has a wonderful network of experienced researchers to guide and support you. Be sure to reach out to the support available to you – your research will be more robust and rewarding for it.
- What’s next for you?
Good question! I’m yet to determine my next research project. However, next steps following this review would be to explore the impact of psychological impairment on reintegration to the community for people following hip fracture – and others returning to the community from hospital – with the eventual aim of developing interventions to improve all aspects of community reintegration (including psychological).